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Erschienen in: Annals of Hematology 7/2004

01.07.2004 | Case Report

Primary adrenal lymphoma presenting as Addison’s disease: case report and review of the literature

verfasst von: George Mantzios, Panagiotis Tsirigotis, Filio Veliou, Iosif Boutsikakis, Lillian Petraki, John Kolovos, Sotirios Papageorgiou, Yannis Robos

Erschienen in: Annals of Hematology | Ausgabe 7/2004

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Abstract

Primary adrenal lymphoma (PAL) is an extremely rare entity and adrenal insufficiency is a common complication. Bilateral enlargement of adrenal glands should raise the suspicion of lymphoma, especially in patients with clinical or laboratory features of adrenal insufficiency. Most of these cases are highly aggressive tumors and should be treated with multiagent chemotherapy. The role of bilateral adrenalectomy and/or radiotherapy cannot be estimated. Our patient with PAL was an 80-year-old man who presented with clinical and laboratory features of adrenal insufficiency. Combination chemotherapy plus rituximab was unsuccessful and our patient died from progressive disease.
Literatur
1.
Zurück zum Zitat Isaacson PG, Norton AJ (1994) Extranodal lymphomas. Churchill Livingstone, Edinburgh Isaacson PG, Norton AJ (1994) Extranodal lymphomas. Churchill Livingstone, Edinburgh
2.
Zurück zum Zitat Lack EE, Gruhn JG (1996) Adrenal glands. In: Damianov I, Linder J (eds) Andersons Pathology, 10th edn. Mosby, St. Louis Lack EE, Gruhn JG (1996) Adrenal glands. In: Damianov I, Linder J (eds) Andersons Pathology, 10th edn. Mosby, St. Louis
3.
Zurück zum Zitat Lack EE (1997) Tumors of the adrenal gland and extra-adrenal paraganglia. Atlas of tumor pathology, fascicle 19. Third series. Armed Forces Institute of Pathology, Washington DC, p 182 Lack EE (1997) Tumors of the adrenal gland and extra-adrenal paraganglia. Atlas of tumor pathology, fascicle 19. Third series. Armed Forces Institute of Pathology, Washington DC, p 182
4.
Zurück zum Zitat Falchook S, Allard JC (1991) CT of primary adrenal lymphoma. J Comput Assist Tomogr 15:1048PubMed Falchook S, Allard JC (1991) CT of primary adrenal lymphoma. J Comput Assist Tomogr 15:1048PubMed
5.
Zurück zum Zitat Kung AWC, Pun KK, Lam K, Wang C, Leung CY (1990) Addisonian crisis as presenting feature in malignancies. Cancer 65:177–179PubMed Kung AWC, Pun KK, Lam K, Wang C, Leung CY (1990) Addisonian crisis as presenting feature in malignancies. Cancer 65:177–179PubMed
6.
Zurück zum Zitat Gondoh M, Sakamoto H, Fujii A, Masuda Y, Watanabe S, Takano Y, Yanagisawa A, Katoh Y (1987) A case of primary non-Hodgkin lymphoma of the left adrenal gland. Rinsho Hoshasen 32:155–158PubMed Gondoh M, Sakamoto H, Fujii A, Masuda Y, Watanabe S, Takano Y, Yanagisawa A, Katoh Y (1987) A case of primary non-Hodgkin lymphoma of the left adrenal gland. Rinsho Hoshasen 32:155–158PubMed
7.
Zurück zum Zitat Huminer D, Garty M, Lapidot M, Leiba S, Borohov H, Rosenfeld JB (1988) Lymphoma presenting with adrenal insufficiency. Adrenal enlargement on computed tomographic scanning as a clue to diagnosis. Am J Med 84:169–172PubMed Huminer D, Garty M, Lapidot M, Leiba S, Borohov H, Rosenfeld JB (1988) Lymphoma presenting with adrenal insufficiency. Adrenal enlargement on computed tomographic scanning as a clue to diagnosis. Am J Med 84:169–172PubMed
8.
Zurück zum Zitat Ito Y, Yamaha M, Koide T, Sakai S, Seko A, Watanabe K (1988) A case of bilateral adrenal non-Hodgkin lymphoma. Hinyokika Kiyo 34:137–140PubMed Ito Y, Yamaha M, Koide T, Sakai S, Seko A, Watanabe K (1988) A case of bilateral adrenal non-Hodgkin lymphoma. Hinyokika Kiyo 34:137–140PubMed
9.
Zurück zum Zitat Robertz-Vaupel GM, Glasmacher AG, Vogel J, Vaupel HA, Koster O, Pizzulli L (1990) Primary bilateral, adrenal, highly malignant B-cell lymphoma with lymphoblastic mengiosis. Klin Wochenschr 68:1076–1081PubMed Robertz-Vaupel GM, Glasmacher AG, Vogel J, Vaupel HA, Koster O, Pizzulli L (1990) Primary bilateral, adrenal, highly malignant B-cell lymphoma with lymphoblastic mengiosis. Klin Wochenschr 68:1076–1081PubMed
10.
Zurück zum Zitat Sasagawa I, Nishimori H, Futagawa S, Sadamori N, Jo T, Kawachi T, Hayashibara T, Tokunaga S, Itoyama T, Tsukasaki K (1991) Primary bilateral adrenal lymphomas in 3 cases. Rinsho Ketsueki 32:1492–1497PubMed Sasagawa I, Nishimori H, Futagawa S, Sadamori N, Jo T, Kawachi T, Hayashibara T, Tokunaga S, Itoyama T, Tsukasaki K (1991) Primary bilateral adrenal lymphomas in 3 cases. Rinsho Ketsueki 32:1492–1497PubMed
11.
Zurück zum Zitat Casolo P, Frassoldati A, Giaco M, Lazzaretti MG, Mosca D, Piccinini L (1991) A case of primary non-Hodgkin lymphoma of the adrenal gland. Minerva Med 82:781–785PubMed Casolo P, Frassoldati A, Giaco M, Lazzaretti MG, Mosca D, Piccinini L (1991) A case of primary non-Hodgkin lymphoma of the adrenal gland. Minerva Med 82:781–785PubMed
12.
Zurück zum Zitat Dobnig H, Silly H, Ohlinger W, Neubauer M, Leb G, Krejs GJ (1992) Successful treatment of primary adrenal insufficiency due to malignant non-Hodgkin’s lymphoma. Clin Invest 70:938–941 Dobnig H, Silly H, Ohlinger W, Neubauer M, Leb G, Krejs GJ (1992) Successful treatment of primary adrenal insufficiency due to malignant non-Hodgkin’s lymphoma. Clin Invest 70:938–941
13.
Zurück zum Zitat Al-Fiar FZ, Pantalony D, Shepherd F (1997) Primary bilateral adrenal lymphoma. Leuk Lymphoma 27:543–549PubMed Al-Fiar FZ, Pantalony D, Shepherd F (1997) Primary bilateral adrenal lymphoma. Leuk Lymphoma 27:543–549PubMed
14.
Zurück zum Zitat Wang J, Sun NCJ, Renslo R, Chuang CC, Tabbarah HJ, Barajas L, French SW (1998) Clinically silent primary adrenal lymphoma: a case report and review of the literature. Am J Hematol 58:130–136CrossRefPubMed Wang J, Sun NCJ, Renslo R, Chuang CC, Tabbarah HJ, Barajas L, French SW (1998) Clinically silent primary adrenal lymphoma: a case report and review of the literature. Am J Hematol 58:130–136CrossRefPubMed
15.
Zurück zum Zitat Sasagawa I, Sadamori N, Itoyama T, Tsukasaki K, Nakamura H, Tomonaga M, Kishikawa M (1995) Primary adrenal lymphoma with chromosomal abnormalities. Acta Haematol 94:156PubMed Sasagawa I, Sadamori N, Itoyama T, Tsukasaki K, Nakamura H, Tomonaga M, Kishikawa M (1995) Primary adrenal lymphoma with chromosomal abnormalities. Acta Haematol 94:156PubMed
16.
Zurück zum Zitat Salvatore JR, Robin RS (1999) Primary bilateral adrenal lymphoma. Leuk Lymphoma 34:111–117PubMed Salvatore JR, Robin RS (1999) Primary bilateral adrenal lymphoma. Leuk Lymphoma 34:111–117PubMed
17.
Zurück zum Zitat Chu P, Costa J, Lachman MF (1996) Angiotropic large cell lymphoma presenting as primary adrenal insufficiency. Hum Pathol 27:209–211PubMed Chu P, Costa J, Lachman MF (1996) Angiotropic large cell lymphoma presenting as primary adrenal insufficiency. Hum Pathol 27:209–211PubMed
18.
Zurück zum Zitat Hsu CW, Ho CL, Sheu WHH, Harn HJ, Chao TY (1999) Adrenal insufficiency caused by primary aggressive non-Hodgkin’s lymphoma of bilateral adrenal glands: report of a case and literature review. Ann Hematol 78:151–154CrossRefPubMed Hsu CW, Ho CL, Sheu WHH, Harn HJ, Chao TY (1999) Adrenal insufficiency caused by primary aggressive non-Hodgkin’s lymphoma of bilateral adrenal glands: report of a case and literature review. Ann Hematol 78:151–154CrossRefPubMed
19.
Zurück zum Zitat Lee KS, Chung YS, Park KH, Kim HS, Kim HM (1999) A case of primary bilateral adrenal lymphoma with partial adrenal insufficiency. Yonsei Med J 40:297–300PubMed Lee KS, Chung YS, Park KH, Kim HS, Kim HM (1999) A case of primary bilateral adrenal lymphoma with partial adrenal insufficiency. Yonsei Med J 40:297–300PubMed
20.
Zurück zum Zitat Takai K, Hiragino T, Isoyama R, Takahashi M, Naito K (1999) A case of primary adrenal lymphoma diagnosed from percutaneous needle biopsy. Urol Int 62:31–33CrossRefPubMed Takai K, Hiragino T, Isoyama R, Takahashi M, Naito K (1999) A case of primary adrenal lymphoma diagnosed from percutaneous needle biopsy. Urol Int 62:31–33CrossRefPubMed
21.
Zurück zum Zitat Wu HC, Shih LY, Chen TC, Chu SH, Tsai CC (1999) A patient with bilateral primary adrenal lymphoma, presenting with fever of unknown origin and achieving long-term disease-free survival after resection and chemotherapy. Ann Hematol 78:289–292CrossRefPubMed Wu HC, Shih LY, Chen TC, Chu SH, Tsai CC (1999) A patient with bilateral primary adrenal lymphoma, presenting with fever of unknown origin and achieving long-term disease-free survival after resection and chemotherapy. Ann Hematol 78:289–292CrossRefPubMed
22.
Zurück zum Zitat Cavanna L, Civardi G, Vallisa D, Berte R (1999) Primary adrenal non-Hodgkin’s lymphoma associated with autoimmune hemolytic anemia: a case diagnosed by ultrasound-guided fine needle biopsy. Ann Ital Med Int 14:298–301PubMed Cavanna L, Civardi G, Vallisa D, Berte R (1999) Primary adrenal non-Hodgkin’s lymphoma associated with autoimmune hemolytic anemia: a case diagnosed by ultrasound-guided fine needle biopsy. Ann Ital Med Int 14:298–301PubMed
23.
Zurück zum Zitat Yamamoto E, Ozaki N, Nakagawa M, Kimoto M (1999) Primary bilateral adrenal lymphoma associated with idiopathic thrombocytopenic purpura. Leuk Lymphoma 35:403–408 Yamamoto E, Ozaki N, Nakagawa M, Kimoto M (1999) Primary bilateral adrenal lymphoma associated with idiopathic thrombocytopenic purpura. Leuk Lymphoma 35:403–408
24.
Zurück zum Zitat Kuyama A, Takeushi M, Munemasa M, Tsutsui K, Aga N, Goda Y, Kanetada K (2000) Successful treatment of primary adrenal non-Hodgkin’s lymphoma associated with adrenal insufficiency. Leuk Lymphoma 38:203–205PubMed Kuyama A, Takeushi M, Munemasa M, Tsutsui K, Aga N, Goda Y, Kanetada K (2000) Successful treatment of primary adrenal non-Hodgkin’s lymphoma associated with adrenal insufficiency. Leuk Lymphoma 38:203–205PubMed
25.
Zurück zum Zitat Ellis RD, Read D (2000) Bilateral adrenal non-Hodgkin’s lymphoma with adrenal insufficiency. Postgrad Med J 76:508–509CrossRefPubMed Ellis RD, Read D (2000) Bilateral adrenal non-Hodgkin’s lymphoma with adrenal insufficiency. Postgrad Med J 76:508–509CrossRefPubMed
26.
Zurück zum Zitat Frankel WL, Shapiro P, Weidner N (2000) Primary anaplastic large cell lymphoma of the adrenal gland. Ann Diagn Pathol 4:158–164PubMed Frankel WL, Shapiro P, Weidner N (2000) Primary anaplastic large cell lymphoma of the adrenal gland. Ann Diagn Pathol 4:158–164PubMed
27.
Zurück zum Zitat Mermershtain W, Liel Y, Zirkin HJ, Lupu L, Lantsberg S, Cohen Y (2001) Primary bilateral adrenal lymphoma relapsing as a solid cerebral mass after complete clinical remission: a case report. Am J Clin Oncol 24:583–585CrossRefPubMed Mermershtain W, Liel Y, Zirkin HJ, Lupu L, Lantsberg S, Cohen Y (2001) Primary bilateral adrenal lymphoma relapsing as a solid cerebral mass after complete clinical remission: a case report. Am J Clin Oncol 24:583–585CrossRefPubMed
28.
Zurück zum Zitat Hahn JS, Choi HS, Suh CO, Lee WJ (2002) A case of primary bilateral adrenal lymphoma (PAL) with central nervous system (CNS) involvement. Yonsei Med J 43:385–390PubMed Hahn JS, Choi HS, Suh CO, Lee WJ (2002) A case of primary bilateral adrenal lymphoma (PAL) with central nervous system (CNS) involvement. Yonsei Med J 43:385–390PubMed
29.
Zurück zum Zitat Miyamura T, Obama K, Takahira H, Uike N, Kozuru M (1993) A case of primary non-Hodgkin’s lymphoma of the adrenal gland presenting with Addison’s disease. Rinsho Ketsueki 34:882–884PubMed Miyamura T, Obama K, Takahira H, Uike N, Kozuru M (1993) A case of primary non-Hodgkin’s lymphoma of the adrenal gland presenting with Addison’s disease. Rinsho Ketsueki 34:882–884PubMed
30.
Zurück zum Zitat Levaltier X, Troussard X, Fournier L,Reznik Y, Reman O, Mahoudeau J, Leporrier M (1994) Primary adrenal lymphoma. Report of a case. Presse Med 23:372–374PubMed Levaltier X, Troussard X, Fournier L,Reznik Y, Reman O, Mahoudeau J, Leporrier M (1994) Primary adrenal lymphoma. Report of a case. Presse Med 23:372–374PubMed
31.
Zurück zum Zitat Mizusawa H, Okaneya T, Yoneyama T, Taguchi I (1995) Primary malignant lymphoma of the adrenal gland: a case report. Hinyokika Kiyo 41:991–994PubMed Mizusawa H, Okaneya T, Yoneyama T, Taguchi I (1995) Primary malignant lymphoma of the adrenal gland: a case report. Hinyokika Kiyo 41:991–994PubMed
32.
Zurück zum Zitat Efremidis SC, Harsoulis F, Douma S, Zafiriadou E, Zamboulis C, Kouri A (1996) Adrenal insufficiency with enlarged adrenals. Abdom Imaging 21:168–171CrossRefPubMed Efremidis SC, Harsoulis F, Douma S, Zafiriadou E, Zamboulis C, Kouri A (1996) Adrenal insufficiency with enlarged adrenals. Abdom Imaging 21:168–171CrossRefPubMed
33.
Zurück zum Zitat Maugendre D, Derrien C, Grulois I, Simon JP, Guilhem I, Poirier JY, Le Prise PY, Allannic H (1998) Primary adrenal lymphoma with latent adrenal insufficiency: a case report and literature review. Ann Endocrinol 59:34–39 Maugendre D, Derrien C, Grulois I, Simon JP, Guilhem I, Poirier JY, Le Prise PY, Allannic H (1998) Primary adrenal lymphoma with latent adrenal insufficiency: a case report and literature review. Ann Endocrinol 59:34–39
34.
Zurück zum Zitat Tazi K, Achour A, Koutani A, Ibn Attya A, Hachimi M, Lakrissa A (1999) Primary non-Hodgkin’s malignant lymphoma of the adrenal gland. Case report and review of the literature. Prog Urol 9:1102–1105PubMed Tazi K, Achour A, Koutani A, Ibn Attya A, Hachimi M, Lakrissa A (1999) Primary non-Hodgkin’s malignant lymphoma of the adrenal gland. Case report and review of the literature. Prog Urol 9:1102–1105PubMed
35.
Zurück zum Zitat Uehara E, Tasaka T, Matsuhashi Y, Suemitsu I, Tamura T, Kuwajima M, Nagai M (2001) Adrenal gland lymphoma accompanied by renal cell carcinoma. Rinsho Ketsueki 42:710–712PubMed Uehara E, Tasaka T, Matsuhashi Y, Suemitsu I, Tamura T, Kuwajima M, Nagai M (2001) Adrenal gland lymphoma accompanied by renal cell carcinoma. Rinsho Ketsueki 42:710–712PubMed
36.
Zurück zum Zitat Toubai T, Akama H, Takagawa M, Ishida S, Kasai M, Tanaka J, Imamura M (2002) Primary adrenal lymphoma: a case report and literature review in Japan. Rinsho Ketsueki 43:851–856PubMed Toubai T, Akama H, Takagawa M, Ishida S, Kasai M, Tanaka J, Imamura M (2002) Primary adrenal lymphoma: a case report and literature review in Japan. Rinsho Ketsueki 43:851–856PubMed
37.
Zurück zum Zitat Fujikata S, Tanji N, Aoki K, Ohoka H, Hojo N, Yokoyama M (2002) Extramedullary plasmacytoma arising from an adrenal gland. Urology 60:514CrossRef Fujikata S, Tanji N, Aoki K, Ohoka H, Hojo N, Yokoyama M (2002) Extramedullary plasmacytoma arising from an adrenal gland. Urology 60:514CrossRef
38.
Zurück zum Zitat Schocket LS, Syed NA, Fine SL (2002) Primary adrenal lymphoma with choroidal metastases. Am J Opthalmol 134:775–776CrossRef Schocket LS, Syed NA, Fine SL (2002) Primary adrenal lymphoma with choroidal metastases. Am J Opthalmol 134:775–776CrossRef
39.
Zurück zum Zitat Alama Zaragoza MA, Robles Iniesta A, Roca Adelantado I, Sales Maicas MA, Navar de Leon MC, Roman Sanchez P (2002) Bilateral primary adrenal lymphoma: an unusual presentation. An Med Interna 19:524–526PubMed Alama Zaragoza MA, Robles Iniesta A, Roca Adelantado I, Sales Maicas MA, Navar de Leon MC, Roman Sanchez P (2002) Bilateral primary adrenal lymphoma: an unusual presentation. An Med Interna 19:524–526PubMed
40.
Zurück zum Zitat Bakkali H, el Omari-Alaoui H, Elghazi el A, Errihani H, Benjaafar N, Elgueddari BK (2002) Bilateral primary adrenal lymphoma. Prog Urol 12:1279–1283PubMed Bakkali H, el Omari-Alaoui H, Elghazi el A, Errihani H, Benjaafar N, Elgueddari BK (2002) Bilateral primary adrenal lymphoma. Prog Urol 12:1279–1283PubMed
41.
Zurück zum Zitat Lu JY, Chang CC, Chang YL (2002) Adrenal lymphoma and Addison’s disease: report of a case. J Formos Med Assoc 101:854–858PubMed Lu JY, Chang CC, Chang YL (2002) Adrenal lymphoma and Addison’s disease: report of a case. J Formos Med Assoc 101:854–858PubMed
42.
Zurück zum Zitat Wang FF, Su CC, Chang YH, Pan CC, Tang KT, Jap TS, Lin HD, Won JG (2003) Primary adrenal lymphoma manifesting as adrenal incidentaloma. J Chin Med Assoc 66:67–71PubMed Wang FF, Su CC, Chang YH, Pan CC, Tang KT, Jap TS, Lin HD, Won JG (2003) Primary adrenal lymphoma manifesting as adrenal incidentaloma. J Chin Med Assoc 66:67–71PubMed
Metadaten
Titel
Primary adrenal lymphoma presenting as Addison’s disease: case report and review of the literature
verfasst von
George Mantzios
Panagiotis Tsirigotis
Filio Veliou
Iosif Boutsikakis
Lillian Petraki
John Kolovos
Sotirios Papageorgiou
Yannis Robos
Publikationsdatum
01.07.2004
Verlag
Springer-Verlag
Erschienen in
Annals of Hematology / Ausgabe 7/2004
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-003-0838-3

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